Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
13010073
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS:.21881 COLUMBUS AVE CONTRACTOR:CALVEY HEATING& PERMIT NO: 13010073 AIR OWNER'S NAME: JESSIE ZHANG. 126 SAN ANTONIO CIR UNIT 9A DATE ISSUED:01/14/2013 OWNER'S PHONE:.4088061002 MOUNTAIN VIEW,CA 94040 PHONE NO:(650)669-3320 LICENSED.CONT OR' DE QARAT ON JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Lric.# �2 1 REPLACE(E)FURNACE,SAME LOCATION Contractor Ch"t ut Date I hereby etlirm that I atm licensed under the provisions of Chapter 9 - (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$2000 . I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:35614031.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that l have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building.construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180DAYS F CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this pe 't:Additionally,the applicant understands and will comply Issue . with all non-point u ce re lations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date ((4 All roofs shall be inspected prior to any roofing material being installed.if a roof is installed without first obtaining an inspection,I agree to remove all new materials for: inspection. ❑ OWNER-BUILDER.DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: . ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the Property,or my employees with wages as their sole compensation, - - will do the:work,and the structure is not intended or offered for sale(See.7044, Business&Professions Code)' 1,as owner;of the property,am,exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE . . construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with theupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 255 5533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. - - Owner or authorized agent: Date:. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of Califomia. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a concoction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that have read this application and state that the above information is correct:I agree to comply with ail city and county ordinances and state laws relating to building construction;end hereby authorize representatives of this city to enter upon.the abovementioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City.of Cupertino against liabilities,judgments, - costs-,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this.permit.Additionally;the applicant understands and will comply with all non point source regulations per theCupertino Municipal Code,Section Licensed Professional 9.18. Signature Date GENERAL PERMIT APPLICATION �� M E P COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION �O 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 .0\ CUPERTINO (408)777-3228•FAX(408)777-3333• building(a�cuoertino.oro M M 'S C ❑PLUM[B�im ❑MECHANICAL []ELECTRICAL ❑MIS,C(ELLANEOUS PROIECLADDRESS �. I `n �M CA e "Na -j S 6 I L 1 U OWNER NAME \v�1 CcW�'^/ PHONE (ftp W� oo E-MAIL STREETADDRESSJm Q< C[TY, STATE,ZIP �f DD (� �1 FAX CONTACT NAME \ `U(� PHONE 1 E-MAIL STREETADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ^ C(,n LICENSENIIMBER �^'J Qd LICENSE TYPE BUS.LIC9 COMPANY NAME I "Y V CJ E-MAIL (_ ( FAX \ 1 STREETADDRESS C_ �I_ 1b Cls CITY.STATE,ZIP `-� /L 1( n(nT G1 /�Q"U PHONE ARCHTECTRNGINEER NAME W.(I LICENSE NUNMER BUS.LIC,yO W / YAW COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD wDUPLFX ❑ MULTI-FANMY PRO=IN WI DLIND ❑ YES PROTECT IN ❑YES IS THE BLDG AN ❑ YES BUDDNG: []CON RCW. URBANWfERFACE AREA ONO FLOODZONE ❑NO EICHLER HOME No DESCRIPTION OF WORK g-Cc TOTAL VALUATION: 2-0b RECEIVED BY: By my signature below,I certify to each f the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have o -ded i correct. I have read the Description of Work and verify it is accurate. I agree to comply With all applicable local ordinances and state laws relating toit sWefion IA,*odze representatives of Cupertino to enter the above-identl5edproperty for inspection puiposcs. Signature of Applicant/Agent Date: S PLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY OVER-THE-COUNTER ❑ EXPRESS Y U ❑ STANDARD U ❑ LARGE ❑ MAJOR AHPMuc 1pp_2011.doc revised 06/21/11 - ��\ Revised: 10/01/2012 Simplified Prescriptive Certificate of Compliance:2008 Residential HVACAlterations CF-IR-ALT-HVAC Climate Zones 1 and 3-7 Site Address: Enforcement Agency: Dale: Permit#: Conditioned Duct insulation Equipment T ' List Minimum Efficiency' Floor Area requircment Thermostat ackaged Unit Fumace MIAFUEJOver 40 ft of ducts % ®COP e[back Served by system added or replaced in ®Indoor Coil ®SEER HSPF_ p sf unconditioned space of k not alre resem,meat be Condensing Unit ®EER_ 13 Resistance ®R 6 (CZ 1, spa installed) ©Other 1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies:13 SEER,78%AFUE,7.7HSPF for typical residential systems. Contractor(Documentation Author's lResponsible Designer's Declaration Statement) . • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance fors,worksheets,calculations,plans and specifications submitted to th enforcen nt agency for approval with the permit app]kation. Name: �� IAk -C rat r Signature: Company: Date: Ilt S� Address: License: T 126 (C 832(4 City/State/Zip: 1...1 v' clor v Phone: 6 O 66q 33 C:) 2008 Residential Compliance Forms March 2010 CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 21881 COLUMBUS AVE DATE: 01/14/2013 REVIEWED BY: MELISSA APN: 356 14 031 BP#: *VALUATION: $2,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION USE: PERMIT TYPE: SFD or Duplex FURN/AC - WORK REPLACE E FURNACE SAME LOCATION SCOPE Mech.Plan Check 0.0 hrs $0.00 Plumb.Plan Cheek Elec.Plan Check Mech.Permit Fee: IMPERMIT Plumb. Permit Fec: Elec. Permit Fee: 'Other Mech.Insp. 1 0.0 1 hrs $45.00 Other Plumb Imp. Other Elec.Imp. ;blech.Gasp.Fee.* Plumb. lisp.Fee: MCC.Imp.Fee. NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District etc). These fees are based on the preUWWna in ormadon available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 gff 711/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Mechanical Suppl:PC Fee: Q Reg. OOT 0.0 hrs $0.00 $133.00 IMFR=<100 Furnace,Forced-Air PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee:Q Reg. OOT Fo.oThrs $0.00 PMEUnit Fee: $0.00 PME Permit Fee: $45.00 Construction Tax: Administrative Fee: IdDMIN $42.00 O Work Without Permit? 0 Yes 0 No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Travel Documentation Fee: ITRA VDOC $45.00 Building or Structure 0 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $133.50 (t`113.001,rM � rTOIAII� EE $266.50 1 1. its. tY... 4 mn.:P vi .5w �w� Revised: 10/01/2012 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: Z" U QVQ PERMIT# OWNER'S NAME: $ PHONE# GENERAL CONTRA I?O�i, 4kV't? Wc t q.S,k Ai BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all.businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL'OR-'FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL S CONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: I ignature Date Please check applicable subcontractors and complete the following information: G/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE# Cabinets &Millwork,_: Cement Finishing, Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood: Glass/Glazing l/ Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/"Coutractor;Signature Date